Minimizing Risk

Workplace injuries may manifest as a thorn in the side of therapists who often move and lift patients and equipment, or spend hours at the computer, maintaining electronic patient records.

Of the nearly 4 million workplace injuries every year, about 50 percent are comprised of back injuries, strains, sprains, cuts and lacerations from lifting, pulling and pushing. In addition, slips, trips and falls cause many sprains and contusions.

According to Scott Parrish, vice president and risk management services director of the Charlotte, N.C.based Carpenter, Cammack & Associates Inc., some of the most common injuries among healthcare professionals include needlestick injuries, back injuries, exposure to infectious diseases, sprains and strains, latex allergies and stressrelated issues.

Richard S. Gilbert, MD, professor of orthopedics at New York Citybased Mount Sinai School of Medicine agrees. “Some of the most common workplace injuries are related to jobs that require repetitive activities,” he says. For example, many injuries are the result of repetitive motion from keyboard use, vibration exposure such as using a jackhammer or other tools or vocations that involve repetitive movements, such as professional musicians or therapy professionals.

Often called cumulative trauma disorder (CTD) or repetitive strain injuries (RSI), these injuries develop over time from strain and overuse. Workers who often use a keyboard, such as programmers, writers or administrative assistants often “think they have carpal tunnel syndrome and are often diagnosed as such,” Gilbert says.

However, he says the majority of hand symptoms are secondary to inflammation, such as tendonitis, not carpal tunnel syndrome. “The hand surgery literature has not found a direct link between the development of carpal tunnel syndrome and keyboarding/typing,” Gilbert says.

Prevention: Posture and Ergonomics

Education is key in preventing cumulative trauma disorder. “The incidence of such conditions has been most effectively reduced by the use of risk screening programs,” Gilbert says. While the medical literature presents conflicting reports as to the cause of these symptoms, prevention methods remain the same.

In order to prevent injuries like tendonitis, shoulder or neck pain, emphasizing good posture is essential. For keyboarders, Gilbert says, “The keyboard should generally be below the elbows, the arms should rest on a support and the wrist should be in a neutral position without deviation upward.”

To prevent neck injuries, he says, “Head rotation should be limited and frequent breaks and stretching can be helpful as well. A ‘light touch’ should be used, as excessive key force may increase the chance of developing symptoms in the hands and fingers.”

Workstations should be set up based on optimal ergonomics to prevent symptoms. “When symptoms do occur,” Gilbert says, “Early recognition and treatment are important to prevent a more significant problem in the future. Many studies have also shown job satisfaction and general ‘life satisfaction’ are protective in terms of developing these symptoms.”

Kurt Klemm PT., Cert. MDT, CEAS Ergonomic equipment is a booming industry, thanks to the increase in workplace injuries. Physicians and therapists are continually working to create solutions to prevent on the job injuries. Kurt Klemm PT., Cert. MDT, CEAS , created the AnterioRest, an adjustable frontal support “that virtually eliminates the postural muscle overload” traditionally seen in dentistry when the medical professional assumes “what is actually a normal working position,” Klemm says.

The AnterioRest helps the PT/OT prevent workplace injuries “by eliminating the postural muscle overuse/overload and the resulting cascade of events from sustained muscle contraction,” Klemm says. “Over time, those include muscle tissue ischemia [decreased bloodflow] that leads to inadequate oxygen and nutrition of the tissue. Inflammation and pain ensues that worsens over time as the continual lack of adequate blood flow exacerbates the problem,” he adds.

According to Klemm, prevention of workplace injuries requires a thorough understanding of the job expectations “to determine which may trigger dysfunction” through repetitive motion or sustained muscle activity injuries. Once an evaluation is conducted, Klemm recommends modifying the worksite “to match the physiological and biomechanical abilities of the worker.”

Clinical Setting

In the healthcare field, needlestick injuries and exposure to blood products are the most concerning type of injury, Gilbert says. For surgeons, exposure to blood products in the operating room poses a significant risk. He says, “This can happen when drawing blood, disposing of waste products and secondary to accidental exposures in the operating room.”

Proper adherence to Occupational Safety and Health Association (OSHA) guidelines and universal precautions are imperative in order to follow proper handling and disposal of blood products, waste products, needles and sharps in the clinical setting.

Gilbert says, “In the operating room, wearing double gloves, proper sterile technique and protective eye guards can prevent accidental exposures.” He adds, “One must assume each and every patient may have a communicable blood disease, and that universal precautions should always be [taken].”

Lifting

According to Klemm, healthcare workers should remember lifting basics when working with patients. He says, “Plan your lift. Get assistance when it is needed. Let your legs [knees and hips] bend; the more hip movement you allow, the straighter you can keep your back.”

He also recommends when lifting, healthcare workers position themselves “so you can keep the object close to you to minimize the extra stress on your back,” Klemm says. For example, try holding a light weight out in front of you at arms length to see how much heavier if feels than when it is in close to your body, he says. This is one example of how positioning can prevent workplace injuries.

Implementing Workplace Safety Programs

In the healthcare setting safety programs evaluate ergonomics and safety both internally and externally, particularly with regard to universal precautions and following OSHA guidelines, Gilbert says. “Hospitals need to be accredited and are thus evaluated externally for safety precautions. Universal precautions, OSHA compliance and safety guidelines during emergencies such as fires or terrorism are probably the areas that are most highly and critically evaluated during the accreditation process.”

When it comes to ongoing workplace safety measures, Gilbert says education and prevention are the best ways to prevent such incidents. “In addition, most facilities, such as my hospital, have a ’needlestick nurse‘ who is reachable 24 hours a day to document and begin treatment when an accidental exposure to blood products occurs.”

While implementing a program may be challenging, it is worth the increased safety and boosted revenue. When working to implement or improve workplace safety programs, Klemm says, “Healthy workers are more efficient, have less lost-time injury claims, return to work quicker if they have been injured, better retention of experience workers/skilled workers, improved employee moral and satisfaction.”

An effective workplace safety plan also reduces administrative costs related to claims management and investigations leading to a more efficient, effective and happier workforce. This, in turn, boosts productivity and profits, according to Klemm. When implementing an ergonomics program for therapy, dentistry or keyboarding professionals, Klemm says the key to progress is training and modifications to create an effective plan.

As workplace injuries increase, claims and cost increase and profits decrease. Klemm says savvy employers recognize the benefits of ergonomic assessment and follow through with appropriate intervention. “Instituting employee safety and effective ergonomic plans minimize losses by lowering medical and worker compensation costs, as well as decreasing costs of employee absenteeism,” he says.

According to the U.S. Department of Labor, workplace safety programs can save $4nbsp;6 for every $1 invested, Klemm says. “As employee morale is higher, turnover is lower, reducing training costs and increasing productivity by retaining experienced staff.”

Anteriorest® Research Basis

The principle behind the Anteriorest has grown out of industry research and recommendations.

For Further ReadingIf you would like to know more about the industry research regarding dental career-related back pain, you can read more in these published articles. “giving the practitioner support on the frontof the body relieves virtually all back muscle effort allowing normal blood flow”